By Tichaona Katsvamutima
The United States has delivered 43,000 doses of lenacapavir to Zimbabwe, in what is expected to be the final shipment of the long-acting HIV prevention injection before Washington ends its health support for the country.
The latest consignment arrived in September, just days before US-funded health programmes are due to close at the end of the month.
Ministry of Health and Child Care AIDS and TB unit director Dr Owen Mugurungi told Parliament during an HIV and AIDS sensitisation workshop in Kadoma that the shipment could be the final contribution from Washington.
“Maybe it was the last kiss from the American government,” Mugurungi said. “They provided us with 43 thousand lenacapavir doses and after that they will not be supporting us. We have to look for additional resources from elsewhere and we will be looking at the Global Fund before generics become available.”
Lenacapavir is a twice-yearly injectable form of HIV pre-exposure prophylaxis PrEP, offering an alternative to daily oral medication.
Zimbabwe began rolling out the injection in February, with the initial programme supported by the United States and the Global Fund. The first phase targeted more than 46,000 people considered at high risk of acquiring HIV across 24 sites.
Zimbabwe had earlier received an initial 2,000 doses, with the rollout beginning through 12 pilot sites in major urban centres.
Mugurungi said demand for the injection had been strong, putting pressure on authorities to secure supplies beyond donor funding.
“The NAC management and Board are already in discussion to ensure we use local resources to procure more doses and not only rely on the Global Fund and other donors,” he said.
Authorities are also considering expanding access beyond public health facilities, including through pharmacies.
“We cannot continue to give this injection in clinics because we also have challenges in accessing clinics, so we will open new frontiers in provision of this,” Mugurungi said.
Zimbabwe is also looking towards generic production of lenacapavir, which could increase availability and reduce procurement costs.
The funding pressure extends beyond lenacapavir.
National AIDS Council chief executive Dr Bernard Madzima, represented by Monitoring and Evaluation Director Amon Mpofu, said the AIDS Levy remained an important source of funding but was no longer enough to meet the needs of the national HIV response.
“Zimbabwe now needs to expand the sources of domestic funding available for HIV so that the progress achieved can be sustained while new and emerging needs are also addressed,” Madzima said.
Senator Angeline Tongogara, chairperson of the Senate Thematic Committee on HIV and AIDS, said Parliament needed to maintain focus on HIV financing, access to medicines and prevention commodities, while strengthening prevention among young people and tackling stigma and discrimination.
“Through legislation, resource allocation and effective oversight, Parliament has a responsibility to make sure these challenges are addressed and that the country’s HIV response remains adequately supported,” she said.
The US funding withdrawal follows Zimbabwe’s decision to pull out of negotiations over a proposed US$367 million five-year bilateral health agreement covering HIV/AIDS, tuberculosis, malaria, maternal and child health, and disease-outbreak preparedness.
The talks broke down over disagreements on health-data provisions. US Ambassador Pamela Tremont said Washington respected Zimbabwe’s decision to decline the agreement and confirmed that US-supported health programmes would conclude at the end of September.
US assistance has supported Zimbabwe’s HIV response for more than two decades, including prevention, treatment, medicines and health workers.
Mugurungi said prevention would remain critical as Zimbabwe faces the loss of major external health support.
“Prevention should remain a priority in order to reduce the infection rate, as this is key for us to make sure that we are forever resilient and overcome the epidemic,” he said.
